硫酸吗啡控释片剂量滴定控制癌性疼痛的临床研究  

Dosage Titration of Morphine Sulfate Controlled-release Tabletsin the Treatment of Cancer Pain

作　　者：肖毅军[1] 司红霞[1] 王迎红 王守章[1] 

机构地区：[1]河南省肿瘤医院内科,郑州市450003

出　　处：《中国肿瘤临床》2000年第2期126-129,共4页Chinese Journal of Clinical Oncology

摘　　要：目的 :评价硫酸吗啡控释片通过剂量滴定对癌性疼痛的治疗作用。方法 :本次研究共收治148例中重度癌症疼痛患者 ,硫酸吗啡控释片的初始剂量一般由10～30mg 开始 ,观察1～2天疼痛无缓解即进行个体剂量滴定 ,按30%～50 %剂量逐渐递增 ,直到疼痛缓解。如经放、化疗后疼痛减轻而需要减量时 ,按30%～50 %剂量递减。整个治疗期间随时进行剂量滴定 ,一直观察到用药终止。结果 :平均初始剂量、维持剂量及最大剂量分别是50mg/天、60mg/天及90mg/天。平均用药持续天数为51 5天 ,最长者达525天。平均达维持剂量及最大剂量天数分别为3天及12天。48 8 %的患者不需增加初始剂量 ,51 2%的需要增加 ,其中47 2 %的患者增加剂量的范围在35%～300 %之间 ,仅1例 (0 7 % )增加剂量达1750 %。疼痛缓解率为97 3 % ,对各种类型疼痛均有效 ,其中内脏痛和骨痛缓解率无显著性差异 (P>0 05)。119例患者治疗停止的原因依次为死亡82例 (68 9 % ) ,放、化疗等使疼痛缓解16例 (10 8 % ) ,病情进展14例 (9 4% ) ,不良反应7例 (4 % )。副作用主要是便秘 (43 9 % )和恶心 (16 9 % )。结论 :作者强调剂量个体化 。Purpose: To evaluate the effect of dosage titration of morphine sulfate controlled-release tablets (MST) in the treatment of cancer pain Methods: One hundred and forty-eight patients with chronic, moderate or severe cancer pain were studied The daily initial dosage of MST started from 10～30mg If the pain was not relieved after 1～2 days' observation, the dosage was increased to 30%～50%each step If the pain was relieved after radiotherapy or chemotherapy, the dosage can be decreased to 30%～50%stepwise During the treatment the dosage titration was carried out whenever it is necessary until ceasation of medicine Results: The mean daily initial dosage, maintenance dosage and maximum dosage were 50mg,60mg and 90mg respectively The mean sustained time of taking medicine was 51 5 days, and the maximum was up to 525 days The mean time of taking maintenance dosage and maximum dosage was 3 days and 12 days respectively 48 8%of the patients did not need to increase their daily initial dosage, 51 2%of patients did The range of increment was 35%to 300%for 43 9%of the patients, only one (0 7%) was up to 1750% The pain relief rate was up to 97 3% MST was effective in relieving all kinds of pain, and no significant difference was noted between visceral pain and bone pain (P>0 05) Among 119 patients who ceased to take the medicine, 82 patients (68 9%) were dead, 16 patients' pain were relieved(10 8%) because of radiotherapy or chemotherapy, 14 patients' situation (9 4%) got worse and 7 patients (4%) had adverse reaction The common side effects were constipation (43 9%) and nausea (16 9%) Conclusion: The authors recommend that MST should be the first choice in the control of chronic cancer pain and that the dosage should be prescribed individually

关 键 词：癌症 疼痛 硫酸吗啡控释片 剂量滴定 

分 类 号：R730.5[医药卫生—肿瘤]